National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Caregiving (1)
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- Children/Adolescents (3)
- Data (1)
- Depression (1)
- Emergency Medical Services (EMS) (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- (-) Healthcare Costs (14)
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- (-) Inpatient Care (14)
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- Medical Expenditure Panel Survey (MEPS) (2)
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- Nursing (1)
- Nutrition (1)
- Outcomes (1)
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- Screening (1)
- Substance Abuse (1)
- Surgery (2)
- Tobacco Use: Smoking Cessation (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedBeck J, Wignall J, Jacob-Files E
Parent attitudes and preferences for discussing health care costs in the inpatient setting.
This study examined parent attitudes towards discussing their child’s health care costs in an inpatient setting with health care providers and others. Semistructured interviews were conducted with 42 parents of children who received care at a tertiary academic children’s hospital with and without chronic disease. Two domains for discussion were identified: factors that influence the parent’s desire to discuss health care costs in the inpatient setting and parent preference regarding the execution of cost discussions. Most parents highlighted concerns regarding physician involvement and felt that it was better explored with a financial counselor or social worker. They also felt that the discussions should be optional.
AHRQ-funded; HS024299.
Citation: Beck J, Wignall J, Jacob-Files E .
Parent attitudes and preferences for discussing health care costs in the inpatient setting.
Pediatrics 2019 Aug;144(2). doi: 10.1542/peds.2018-4029..
Keywords: Caregiving, Children/Adolescents, Healthcare Costs, Inpatient Care, Hospitalization, Hospitals
Chan CW, Green LV, Lekwijit S
Assessing the impact of service level when customer needs are uncertain: an empirical investigation of hospital step-down units.
In this study, the authors focused on estimating costs and benefits in a complex healthcare setting where the major differentiation among server types is the intensity of the service provided. They used data from ten hospitals and found that a step-down unit may be a cost-effective way to treat patients when used for those who are post-intensive care unit. However, they also found that the impact of step-down-unit care is more nuanced for patients admitted from the emergency department and may result in increased mortality risk and hospital length of stay for patients who should be treated in the intensive care unit. The authors recommended more study in this area.
AHRQ-funded; HS018480.
Citation: Chan CW, Green LV, Lekwijit S .
Assessing the impact of service level when customer needs are uncertain: an empirical investigation of hospital step-down units.
Management Science 2019 Feb;65(2):751-75. doi: 10.1287/mnsc.2017.2974..
Keywords: Care Management, Healthcare Costs, Healthcare Delivery, Hospitals, Inpatient Care
Nathan H, Thumma JR, Ryan AM
Early impact of Medicare accountable care organizations on inpatient surgical spending.
This study evaluated whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. Medicare Shared Savings Programs (MSSP) have shown some modest success in reducing overall medical spending, but has not been studied on its impact in reducing surgical spending. Medicare claims from 2010 to 2014 were evaluated for patients aged 65 to 99 years undergoing 6 common elective surgical procedures: abdominal aortic aneurysm, colectomy, coronary artery bypass grafting, hip or knee replacement, or lung resection. A total of 341,675 patients at 427 ACO hospitals and over 1 million matched controls at non-ACO hospitals were used to compare surgical costs. There was not an overall reducing in total Medicare patients between the two hospital types.
AHRQ-funded; HS024763.
Citation: Nathan H, Thumma JR, Ryan AM .
Early impact of Medicare accountable care organizations on inpatient surgical spending.
Ann Surg 2019 Feb;269(2):191-96. doi: 10.1097/sla.0000000000002819..
Keywords: Healthcare Costs, Hospitals, Inpatient Care, Medicare, Surgery, Quality of Care
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Cartmell KB, Dismuke CE, Dooley M
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
In 2014, the Medical University of South Carolina (MUSC) implemented a Tobacco Dependence Treatment Service (TDTS) consistent with the Joint Commission (JC) standards recommending that hospitals screen patients for smoking, provide cessation support, and follow-up contact for relapse prevention within 1 month of discharge. This paper examined whether exposure to the TDTS influenced downstream health care charges 12 months after patients were discharged from the hospital.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dismuke CE, Dooley M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
Med Care 2018 Oct;56(10):883-89. doi: 10.1097/mlr.0000000000000979..
Keywords: Healthcare Costs, Inpatient Care, Screening, Substance Abuse, Tobacco Use: Smoking Cessation
Keohane LM, Trivedi AN, Mor V
The role of Medicare's inpatient cost-sharing in Medicaid entry.
This study sought to isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. It concluded that Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation.
AHRQ-funded; HS023016.
Citation: Keohane LM, Trivedi AN, Mor V .
The role of Medicare's inpatient cost-sharing in Medicaid entry.
Health Serv Res 2018 Apr;53(2):711-29. doi: 10.1111/1475-6773.12682.
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Keywords: Healthcare Costs, Inpatient Care, Medicaid, Medicare
Hsu DY, Gordon K, Silverberg JI
Serious infections in hospitalized patients with psoriasis in the United States.
The researchers sought to determine rates and predictors of serious infections in hospitalized psoriasis patients and quantify costs of care, length of stay, and mortality. Among patients with psoriasis, rates of serious infections increased over all time intervals analyzed and were significantly higher compared with those without psoriasis across all time intervals.
AHRQ-funded; HS023011.
Citation: Hsu DY, Gordon K, Silverberg JI .
Serious infections in hospitalized patients with psoriasis in the United States.
J Am Acad Dermatol 2016 Aug;75(2):287-96. doi: 10.1016/j.jaad.2016.04.005..
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Costs, Inpatient Care
Sonik RA
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
This study investigated the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. It found that compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines.
AHRQ-funded; HS000062.
Citation: Sonik RA .
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
Am J Public Health 2016 Mar;106(3):443-8. doi: 10.2105/ajph.2015.302990.
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Keywords: Medicaid, Nutrition, Healthcare Costs, Inpatient Care
Grenda TR, Krell RW, Dimick JB
Reliability of hospital cost profiles in inpatient surgery.
This study sought to discover whether Medicare payments for surgery can reliably compare hospital costs. It found that episode payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume operations. These findings suggest that hospital cost profiles based on Medicare claims data may be used to benchmark efficiency, especially for more common procedures.
AHRQ-funded; HS000053.
Citation: Grenda TR, Krell RW, Dimick JB .
Reliability of hospital cost profiles in inpatient surgery.
Surgery 2016 Feb;159(2):375-80. doi: 10.1016/j.surg.2015.06.043..
Keywords: Inpatient Care, Surgery, Healthcare Costs, Medicare, Data
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Smith MW, Friedman B, Karaca Z
AHRQ Author: Friedman B, Karaca Z, Wong HS
Predicting inpatient hospital payments in the United States: a retrospective analysis.
The researchers evaluated whether payment-to-charge ratios (PCRs) can be predicted for hospitals in States that do not provide detailed financial data. They found that inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance.
AHRQ-authored.
Citation: Smith MW, Friedman B, Karaca Z .
Predicting inpatient hospital payments in the United States: a retrospective analysis.
BMC Health Serv Res 2015 Sep 10;15(1):372. doi: 10.1186/s12913-015-1040-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Healthcare Costs, Hospitalization
Galarraga JE, Mutter R, Pines JM
AHRQ Author: Mutter R
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
The objective of this study was to identify the cost differences in payments and charges for ambulatory care-sensitive conditions (ACSC) visits in three different hospital-based settings: outpatient visits, ED visits, and inpatient admissions. After adjusting for patient demographics and comorbid conditions, charges for an inpatient ACSC visit were four times higher ($11,414 vs. $2,563) when compared to an ED visit.
AHRQ-authored.
Citation: Galarraga JE, Mutter R, Pines JM .
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
Acad Emerg Med. 2015 Feb;22(2):172-81. doi: 10.1111/acem.12579..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Emergency Medical Services (EMS), Ambulatory Care and Surgery, Inpatient Care
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing